| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE STE 300 RIVERSIDE, CA 92501 | UNITED HEALTHCARE INSURANCE COMPANY | $187K | — | $187K | 4.22% |
| INTERCARE INSURANCE SOLUTIONS, INC. Filed as: INTERCARE INSURANCE SOLUTIONS INC | 4371 LATHAM STREET STE 101 RIVERSIDE, CA 92501 | UNITED HEALTHCARE INSURANCE COMPANY | — | $12K | $12K | 0.28% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: HUB INTERNATIONAL INS SVCS INC | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | UNITED HEALTHCARE INSURANCE COMPANY | $76K | — | $76K | 4.08% |
| INTERCARE INSURANCE SOLUTIONS, INC. Filed as: INTERCARE INSURANCE SOLUTIONS INC | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | UNITED HEALTHCARE INSURANCE COMPANY | $5K | — | $5K | 0.26% |
| GRIFFIN, STEVEN, RAY | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $861 | $8K | 15.29% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: HUB INTERNATIONAL INS SVCS INC | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $168 | $3K | 6.16% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 452 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 452 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITED HEALTHCARE INSURANCE COMPANY | 778 | $6.3M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 326 | $234K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 174 | $50K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 174 | $50K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 174 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 778 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.